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Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial

BACKGROUND: General Practitioners (GPs) play an important role in the follow-up of patients after deliberate self-poisoning (DSP). The aim was to examine whether structured follow-up by GPs increased the content of, adherence to, and satisfaction with treatment after discharge from emergency departm...

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Autores principales: Grimholt, TK, Jacobsen, D., Haavet, OR, Sandvik, L., Jorgensen, T., Norheim, AB, Ekeberg, O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604741/
https://www.ncbi.nlm.nih.gov/pubmed/26467530
http://dx.doi.org/10.1186/s12888-015-0635-2
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author Grimholt, TK
Jacobsen, D.
Haavet, OR
Sandvik, L.
Jorgensen, T.
Norheim, AB
Ekeberg, O.
author_facet Grimholt, TK
Jacobsen, D.
Haavet, OR
Sandvik, L.
Jorgensen, T.
Norheim, AB
Ekeberg, O.
author_sort Grimholt, TK
collection PubMed
description BACKGROUND: General Practitioners (GPs) play an important role in the follow-up of patients after deliberate self-poisoning (DSP). The aim was to examine whether structured follow-up by GPs increased the content of, adherence to, and satisfaction with treatment after discharge from emergency departments. METHODS: This was a multicentre, randomised trial with blinded assignment. Five emergency departments and general practices in the catchment area participated. 202 patients discharged from emergency departments after DSP were assigned. The intervention was structured follow-up by the GP over a 6-month period with a minimum of five consultations, accompanied by written guidelines for the GPs with suggestions for motivating patients to follow treatment, assessing personal problems and suicidal ideation, and availability in the case of suicidal crisis. Outcome measures were data retrieved from the Register for the control and payment of reimbursements to health service providers (KUHR) and by questionnaires mailed to patients and GPs. After 3 and 6 months, the frequency and content of GP contact, and adherence to GP consultations and treatment in general were registered. Satisfaction with general treatment received and with the GP was measured by the EUROPEP scale. RESULTS: Patients in the intervention group received significantly more consultations than the control group (mean 6.7 vs. 4.5 (p = 0.004)). The intervention group was significantly more satisfied with the time their GP took to listen to their personal problems (93.1 % vs. 59.4 % (p = 0.002)) and with the fact that the GP included them in medical decisions (87.5 % vs. 54. 8 % (p = 0.009)). The intervention group was significantly more satisfied with the treatment in general than the control group (79 % vs. 51 % (p = 0.026)). CONCLUSIONS: Guidelines and structured, enhanced follow-up by the GP after the discharge of the DSP patient increased the number of consultations and satisfaction with aftercare in general practice. Consistently with previous research, there is still a need for interventional studies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01342809. Registered 18 April 2011. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-015-0635-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-46047412015-10-15 Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial Grimholt, TK Jacobsen, D. Haavet, OR Sandvik, L. Jorgensen, T. Norheim, AB Ekeberg, O. BMC Psychiatry Research Article BACKGROUND: General Practitioners (GPs) play an important role in the follow-up of patients after deliberate self-poisoning (DSP). The aim was to examine whether structured follow-up by GPs increased the content of, adherence to, and satisfaction with treatment after discharge from emergency departments. METHODS: This was a multicentre, randomised trial with blinded assignment. Five emergency departments and general practices in the catchment area participated. 202 patients discharged from emergency departments after DSP were assigned. The intervention was structured follow-up by the GP over a 6-month period with a minimum of five consultations, accompanied by written guidelines for the GPs with suggestions for motivating patients to follow treatment, assessing personal problems and suicidal ideation, and availability in the case of suicidal crisis. Outcome measures were data retrieved from the Register for the control and payment of reimbursements to health service providers (KUHR) and by questionnaires mailed to patients and GPs. After 3 and 6 months, the frequency and content of GP contact, and adherence to GP consultations and treatment in general were registered. Satisfaction with general treatment received and with the GP was measured by the EUROPEP scale. RESULTS: Patients in the intervention group received significantly more consultations than the control group (mean 6.7 vs. 4.5 (p = 0.004)). The intervention group was significantly more satisfied with the time their GP took to listen to their personal problems (93.1 % vs. 59.4 % (p = 0.002)) and with the fact that the GP included them in medical decisions (87.5 % vs. 54. 8 % (p = 0.009)). The intervention group was significantly more satisfied with the treatment in general than the control group (79 % vs. 51 % (p = 0.026)). CONCLUSIONS: Guidelines and structured, enhanced follow-up by the GP after the discharge of the DSP patient increased the number of consultations and satisfaction with aftercare in general practice. Consistently with previous research, there is still a need for interventional studies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01342809. Registered 18 April 2011. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-015-0635-2) contains supplementary material, which is available to authorized users. BioMed Central 2015-10-14 /pmc/articles/PMC4604741/ /pubmed/26467530 http://dx.doi.org/10.1186/s12888-015-0635-2 Text en © Grimholt et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Grimholt, TK
Jacobsen, D.
Haavet, OR
Sandvik, L.
Jorgensen, T.
Norheim, AB
Ekeberg, O.
Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
title Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
title_full Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
title_fullStr Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
title_full_unstemmed Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
title_short Structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
title_sort structured follow-up by general practitioners after deliberate self-poisoning: a randomised controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604741/
https://www.ncbi.nlm.nih.gov/pubmed/26467530
http://dx.doi.org/10.1186/s12888-015-0635-2
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